The Central Role of the Development of
the Prefrontal Cortex Executive Functions in ADHD
Although it is unlikely that ADHD is a unitary disorder, most research implicates a key role of the frontal cortex, in particular the prefrontal cortex (PFCX). Since the PFCX provides executive control over brain activity that regulates thinking and behavior, dysfunction of this cortical area and its network with the rest of the brain can lead to a variety of cognitive and behavioral imbalances similar to the central deficits of ADHD.
The PFCX regulates “self-control.” Self-control is understood in terms of self-directed action for increasingly successful, self-serving outcomes. This includes the ability to regulate response inhibition and as well as attention across time. ADHD is considered to be a disorder of the proper development of self-directed behavior. In fact, research documents that a lack of PFCX-dependent response inhibition may lie at the core of this disorder, leading to a cascade of imbalances in a variety of dependent developing cognitive systems that then appear as varying individual expressions of ADHD symptoms.
PFCX Dysfunction in ADHD Brains
| |
 |
|
 |
Normal
Brain |
ADHD
Brain |
|
|
| On the left is a scan of a normal child’s brain, depicting relatively homogeneous pattern of blood flow related to normal patterns of neural activity; the scan on the right is of an ADHD child’s brain, with numerous regions displaying marked reduction in brain metabolism. |
| |
In addition to numerous neuropsychological tests and brainwave measures, neuroimaging studies graphically demonstrate that ADHD is associated with abnormalities of functioning and metabolism in the frontal cortex, the brain’s executive decision-making center. These abnormalities, called “functional lesions,” appear in advanced neuroimaging scans as “holes” in the brain (see illustration). Dysfunction of the PFCX is associated with lack of impulse control, poor emotional stability, and lack of socially acceptable behavior. Such abnormalities are also associated with violent behavior— another crucially important issue in our nation’s schools.
Risks of Psychotropic Drug
Treatment for ADHD
The only accepted treatment of this dysfunction, which has risen 500% in the last decade, is drug therapy, using psychotropic agents such as Ritalin. Ritalin and similar medications are used because they are able to suppress the basic symptoms in the majority of children. Few children and parents are happy about the use of these drugs, fueling a decade-long, basically unsuccessful, search for practical and effective non-drug alternatives.
The primary use of psychotropic drugs in our children is alarming:
- The number of preschool children being treated with medication for ADHD increased 300 percent between 1990 and 1995.
- The number of adolescents ages 15 to 19 taking medication for ADHD has increased by over 300 percent in the last 15 years.
- About 80 percent of the 11 million prescriptions written each year for methylphenidate (Ritalin is the brand name) are written for children.
Most parents, educators and physicians would rather not give children drugs over long periods of time for a number of reasons:
- These drugs exert toxic, negative side-effects, which are most often expressed in children as problems with sleep, digestion, and/or physical growth.
- These drugs merely suppress the symptoms without necessarily treating the root cause of the disorder. Since science does not understand why these symptoms appear and how the root cause may differ from child to child, a superficial pharmacological approach is used.
- These drugs are associated with significant risk for substance abuse among ADHD children.
- These drugs become lifelong prescriptions for about 40-50 percent of all children.
- These drugs have never been properly tested for use in children. The effects of long-term usage on the physical and cognitive processes in developing brains are not known, and do not bode well.
Due to the lack of information on the effects of ADHD medication, more and more families are searching for drug-free alternatives to alleviate the disruptive effects of ADHD in their children.
Non-Drug Solution for ADHD Children
The University of Missouri is planning a collaborative ADHD research project with the Brain Research Institute. This research will examine the effectiveness of an alternative, non-drug approach to treating ADHD children. We have chosen the scientifically documented and widely used Transcendental Meditation program as a non-drug intervention for ADHD.
Scientific research on the Transcendental Meditation program verifies its wide-ranging benefits, with over 600 scientific research studies conducted at 200 independent research institutions in 35 countries. In particular, this research shows that TM practice facilitates childhood cognitive development and produces immediate and long-term coherence in brain wave functioning, especially the PFCX, as well as increased blood flow to the brain.
Scientifically Documented Non-Drug Intervention for ADHD The choice of Transcendental Meditation for this collaborative research project is based on the accumulated scientifically documented benefits of TM practice in mind/body health, field experience teaching ADHD children, and general ease of application of this meditation technique.
- The TM Practice Enlivens Subjective and Objective Estimates of Self-Regulation: The practice of Transcendental Meditation provides regular, repeated experience of more self-referral modes of thinking and brain activity. Individuals report that during TM, they experience a deep silent, unbounded value of their self. Science refers to this state of self-referral awareness as restful alertness or transcendental consciousness, in which the body is deeply rested and balanced while the mind remains wide awake and alert. Since the core problem with ADHD children may well be a lack of proper development of sense-of self and, thus, the normal, proper development of self-regulation in thinking and behavior, one would expect the practice of TM to facilitate this developmental process and correct any imbalances in the brain and mind. In turn, meditation would help correct the overt symptoms of inattention and/or impulse control in ADHD children.
- General Research Conclusion in Support of TM Implementation: The collective body of scientific research on TM can be viewed as a large-scale integration of brain function. In a relatively short period of time, the TM technique can exert a powerful restorative influence and bring about proper functioning in many chronic diseases. It appears that the global brainwave coherence that occurs during the natural, effortless practice underlies the widespread and remarkable restoration of order and balance in mind and body.
- TM Improves PFCX Executive Functions: Central to this system-wide neurophysiological integration is the enhancement of PFCX executive functions, which are known to support most of the fundamental elements of normal childhood development of cognitive and motor capacity. Research demonstrates that TM practice leads to marked increases in brainwave coherence, which correlate with, for example, increased self-esteem, experience of self-referral awareness, intelligence, academic performance, emotional harmony, creativity, concept learning, and moral reasoning.
- TM Should Improve the Core Symptoms of ADHD: Considerable research on TM indicates the ability of this meditation practice to positively influence the core symptoms of ADHD. Many studies can be cited (see website summary chart and review paper) that indicate the practice of TM can beneficially affect problems in inattention, hyperactivity, and impulsivity.
- TM Develops and Enhances Childhood Cognitive Development: As numerous studies have documented, a unique advantage of the TM technique is that while correcting various forms of mind/body imbalance, TM practice also develops the inner latent mental potential of the child—intelligence, creativity, emotional stability, and ego development.
Three research studies to be published in December in the Journal of Social Behavior and Personality demonstrate acceleration of normal stages of cognitive development in young meditating children. Thus, the normal development processes of thinking and self-concept in children are enhanced by meditation. Standard psychological tests show that children practicing the children’s version of the TM technique demonstrate greater analytic ability, conceptual maturity, working memory, and sustained attention, as well as marked increases in general intelligence and self-concept. These results are consistent with meditation inducing increased integration of PFCX function. Children between approximately 5 and 10 years of age experience a remarkable and profound shift in self-development from a state in which the awareness is dominated, i.e., controlled, by simple perceptual representations to one in which the children begin to think from a more abstract, stable, and powerful level of mind. This normal transition is accelerated and shortened in children who practice TM, again suggesting a positive impact of TM on frontal cortical function.
Unpublished pilot data from the BRI also support the integrating and maturing influence of TM on the PFCX in children. Data using (1) Locus of Control (internal vs. external frame of reference), (2) Emotional stability scale, and (3) Decision-Making task (to examine development of delayed gratification and real-life decision-making) on meditating children show significant differences (enhancement) between meditating and non-meditating children. Both a standardized test of risky behavior in children developed by the Center for Disease Control and a computerized test of maturity of decision-making indicate that meditating children score significantly better than nonmeditating children in many categories, consistent with more mature PFCX functioning. Finally, a study on the correlation of intelligence and brainwave coherence in meditating children shows that prefrontal cortex coherence is significantly correlated with intelligence in meditating students.
- TM Benefits to Brains of Violent and Drug-Damaged Individuals: Another source of research support for expecting improvement in ADHD children is the 35 years of published data indicating the profound ability of TM to correct problems of violent, antisocial thinking and behavior, as well as substance abuse. Given the remarkable improvement in response to TM of most likely less flexible and more severely damaged brains of incarcerated individuals and drug and alcohol addicts, the influence of meditation on the young and highly adaptable brain is expected to be significant, as cited above.
- Field Experience Teaching TM to ADHD Children: During the past four decades, millions of Americans have learned the TM technique, and many of them have been ADHD children. TM teachers have consistently reported immediate and cumulative benefits in these children. These anecdotal reports support the concept that increased neurophysiological order, generated spontaneously during the TM practice, allows the child’s brain to readjust, to regain balance, and to normalize developmental processes.
- Implementation of TM is Easy: Fortunately, the TM technique is easy to learn and easy to practice. Children practice TM quietly on their own, without much guidance needed, so the practice creates an enhanced degree of self-sufficiency for the child. And numerous mind/body benefits occur independent of any particular state of emotions or motivation of the child—and independent of beliefs, attitudes, age, or level of intelligence. Thus, any child who wishes to begin the practice can be properly instructed and can be expected to gain the reported benefits.
Expected Results from the Collaborative Research Project We expect, based on the decades of TM research and the experiences of TM instructors teaching ADHD children, that TM will greatly improve the integration of the PFCX and its executive functions and may well repair functional lesions and eliminate the “holes” in the brain that cause ADHD.
We will use a number of neuropsychological tests and brainwave analyses to track changes in brain and cognitive function over a 12-month period. Improved PFCX activity is expected to closely correlate with improvement in attention and/or motor function. Based on prior research, the practice should also enhance intelligence, creativity, cognitive development, emotional stability, ego development, moral reasoning, self-esteem, self-confidence, and academic performance, while eliminating any substance abuse and reducing any sleep and digestive problems.
TM should accelerate the natural developmental consolidation of awareness at a deeper, more holistic level, of functioning, allowing children to shift from a perceptual level to deeper, more stable, abstract thinking level.
This collaborative research project will provide valuable documentation as to the effects of TM practice on the brains and behavior of ADHD children. If Transcendental Meditation can be shown to relieve ADHD by rebalancing brain functioning, this research would electrify the educational community and help end the struggles of ADHD children and their families.
Funds Needed to Support Non-Drug Intervention Research Project
The research budget is rather modest: about $120,000 over a 12-month period. These funds would cover TM instruction fees for some ADHD children participating in the project; lab costs for research tests of all study participants; and staffing and overhead costs for a year-long research project.
Such a modest investment will bring significant benefits:
- Help restore the brain physiology of thousands of ADHD-afflicted children so that they can begin to enjoy their birthright—“total brain functioning”
- Provide a powerful tool to educate the teachers and youth of this country about effective alternatives to current drug therapy for ADHD
- Catalyze philanthropic and governmental funding to support further research as well as implementation of these programs in schools across the nation
- Bring great and lasting joy and fulfillment to all ADHD children—and to their families, teachers, and friends
All of us here at the Brain Research Institute and the Institute of Science, Technology and Public Policy are very enthusiastic about this crucially important project, and we are eager to start as soon as possible.
Please help ADHD children around the globe by supporting this research project and helping us to provide concrete evidence of an effective non-drug approach to ADHD. Together, we can offer an alternative to a “Generation-Rx”.
Action Steps
- Please let us know if you are interested in this project. More information is available online at www.brainresearchinstitute.org. Or call us at 641-472-1145. We also encourage you to sign up at the website for our free BRI eNews, which will keep you up to date about our progress.
- Please share this information with your friends. By doing so, you can help bring the knowledge of this research project to every household concerned with ADHD and education.
We have an unprecedented opportunity through this research project to transform the lives of our nation’s children. We look forward to hearing from you.
With all best wishes,
Alarik Arenander
Director |
